Doctors ready to fight bully medical aid schemes
A PRETORIA psychologist has joined the Educators Union of South Africa (Eusa) campaign to have the Government Medical Aid Scheme (Gems), one of the country’s biggest medical aid schemes, scrapped.
Dr Senathi Fisha said doctors were ready to crack the whip on medical aids such as Gems.
Government employees forfeit their medical aid subsidy if they choose to belong to other medical aid schemes.
Tasked with collecting the complaints from doctors who were also fed up with the scheme and other medical aids in the country, Fisha has her own score to settle with medical aids, too.
She was banned by Gems and Discovery Medical Aid and accused of corruption, but not charged as she was cleared of the allegations.
“I was accused of being too ‘busy’. When you’re black and run a successful health-care facility, you attract a lot of attention from medical aids. They investigated me for having too many clients, only to find that I had about 10 doctors working for me, which explained the volume of clients that I had. They found nothing on me, but they still didn’t want to work with me,” she explained.
“The only thing standing in the way of the success of doctors and health-care service delivery to the people of South Africa are medical aids who are bullying doctors in order to dodge paying for services rendered,” said Fisha.
Fisha said she became interested in Eusa’s campaign because she was aware of the challenges faced by doctors, especially black doctors.
She said things such as spy cameras and fake patients were some of the tactics used by medical aids to victimise doctors.
“It is about time we exposed the constant abuse and bullying that doctors experience with medical aids. We are suffering and treated like criminals,” she said. “Medical aids operate like a monopoly. Proper monitoring mechanisms should be in place,” said Fisha.
Eusa leaders met the Gems principals last month to table some of the complaints by members, some of whom were apparently being turned away by doctors who were refusing to work with Gems. The union also complained about members’ funds “disappearing” and being exhausted as early as February without explanations.
Although Gems principal Dr Guni Goolab had promised to investigate the members’ complaints, no resolutions were made at the meeting.
Eusa president Issac Bhengu said that their campaign had led to more doctors and other stakeholders coming forward with the challenges they faced.
“We have written to the Competition Commission and asked them to intervene in the unfair competition in the medical aid sector. We have also alerted the Minister of Public Servants and Administration Ayanda Dlodlo for an urgent meeting,” said Bhengu.
After they were given a week to respond, the Medical Aid Scheme Council had not yet done so at the time of publication.